A Change in Environment: Why Residential Addiction Treatment Can Optimize Recovery

In June of 1971, as the Vietnam War was raging, another war began. Having learned that a full 15% of U.S. servicemen stationed in Vietnam were addicted to heroin, President Richard Nixon gave a speech not only outlining rehabilitation services for Vietnam veterans, but increased funding for drug abuse prevention, expansion of drug regulations, more severe criminal sentencing for drug dealers and traffickers, and the creation of The Special Action Office of Drug Abuse Prevention. This, he said, was needed to “wage an effective war against heroin addiction.” In effect, heroin addiction in Vietnam radically changed the landscape of drug policy in the United States and throughout the world, acting as the impetus for the war on drugs that is still surging 40 years after the war in Vietnam ended. But it also did something else, something remarkable that was not fully realized until decades later; it changed the way we understand addiction and how to treat it.

In order to prevent an onslaught of addicted servicemen returning from Vietnam, the government launched Operation Golden Flow, requiring all servicemen to test clean for heroin via urinalysis before being allowed to return home. If they were actively using, they were kept in Vietnam until they stopped. Despite this, expectations for rehabilitation were not high; the relapse rate for heroin addicts in the general population was 90%. As Dr. Sanjay Gupta writes, “[Heroin] was thought to be the most addictive substance ever produced and impossible to escape.” But data collected by Dr. Lee Robins, a psychiatric researcher tasked with studying the behavior of addicted servicemen upon repatriation, revealed something extraordinary: only 5% of those addicted to heroin while in Vietnam relapsed in their first year home, and only 12% used within three years. What was responsible for this unprecedented recovery rate? What did the servicemen experience that addicts in the U.S. didn’t?

The Relationship Between Environment and Behavior


In the 1970s, addiction treatment was centered around a belief that changing behavior was a conscious process of reorganizing goals and beliefs; if you learn that smoking is bad for you and tell yourself you shouldn’t do it, you will quit. What the addicted servicemen introduced was the idea that our physical environments shape our behaviors in ways that either reinforce them on a subconscious level, or allow us to disrupt them. Stephen Neal, a psychologist specializing in behavior change, says, “People, when they perform a behavior a lot—especially in the same environment, same sort of physical setting—outsource the control of the behavior to the environment.” In other words, our behaviors are not simply the outcomes of our conscious will, but powerfully connected to the subconscious impact of the physical environments in which we act.Because the servicemen’s home environments had not been the site of addiction, their addictions were not conditioned to find expression there, allowing them to overwhelmingly move from addiction-led behavior to recovery-based behavior.

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The Environmental Benefits of Residential Addiction Treatment


The impact of environmental change on addiction treatment and recovery goes some way towards explaining why many people struggling with addiction find that residential addiction treatment is more effective than outpatient treatment. While residential treatment programs like Alta Mira’s have multiple advantages, including 24-hour monitoring, intensive therapies, and immersion in a community of recovery that cannot be replicated in an outpatient setting, the residential part of residential treatment may be inherently conducive to breaking addiction. Freed from your everyday environmental triggers, you are not fighting against your unconscious self; you don’t have to negotiate your desire for recovery with the involuntary, swelling desire to use when you pass that street, when you sleep in that bed, when you sit on that sofa, when it’s your lunch hour at work. In residential treatment, you can experience yourself without the controlling influence of the surroundings you overtly and subliminally associate with using. Without your environment competing with your desire for recovery, you can be more open to behavioral change and learning, enhancing your ability to engage with and incorporate recovery strategies to establish new, healthy patterns.

Sustaining Recovery


But what happens when you return to your normal environment? Will your old habits return? At Alta Mira, we recognize that we are only a small part of your recovery journey. As such, we are committed to not just helping you get sober, but helping you stay sober by preparing you for life beyond residential addiction treatment. To optimize your chances of sustainable recovery, we engage in extensive aftercare planning to give you the tools you need to carry your recovery forward, as well as identifying potential environmental triggers and creating strategies to address them. For some, this may mean avoiding certain places, while for others it could mean something as significant as moving. Seemingly small changes like rearranging furniture or replacing the chair where you used to drink every night can break the link between environment and addictive behavior. We have observed that our comprehensive addiction treatment curriculum and aftercare planning give our clients the internal resources to create lasting behavioral change that stays with them when they go home.

If you believe you will be vulnerable to relapse upon returning home, but no longer need the immersive treatment of a residential program, there are other options. For those who do not feel they can re-enter their previous environments without compromising their recovery, sober living environments can offer social and environmental protections against relapse to help you maintain your sobriety and strengthen your recovery. If you do want to return to your home environment, intensive outpatient programs give you the structure and support you need to re-integrate yourself in your everyday life while engaged in active, meaningful recovery. By identifying your own environment needs and designing a recovery strategy to address them, you can ensure that your healing journey is not only successful in keeping you sober, but is also deeply empowering.

Alta Mira provides comprehensive residential addiction treatment for people struggling with substance abuse and co-occurring mental health disorders and process addictions. Contact us to find out more about our innovative program and how we can help you or your loved one find lasting recovery.